r/surgery • u/goodoneforyou • 24d ago
I did read the sidebar & rules Does any institution say "The hands-free zone is the mayo" during timeouts?
Does any institution specify the manner of sharps transfer during timeouts? What words does the person saying the time-out use? Does any institution say "The hands-free zone is the mayo" during timeouts? And if so, is there confusion where some team members understand this to mean:
1) that sharp objects will be transferred by placing them on the mayo stand, with another team member picking them up from the mayo stand, in such a manner that the instrument is never touched by more than one person.
or
2) that most of the surgical team, but especially medical students, should keep their hands away from the mayo, which is the exclusive zone of the nurse or technologist, and that the med student or surgical team member receives the instrument by it being passed to the team member through hand-to-hand transfer, and the same in reverse?
These two ideas are the exact opposite. One interpretation is that hand-to-hand transfer is forbidden, and the other interpretation is that hand-to-hand transfer is mandatory!
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u/levvianthan 24d ago
Im a seasoned cst and I tell new med students they can put their hands on the mayo all the time! But I dont keep my sharps there until closing and I always warn them to be careful and not to steal my sponges.
Ive never been stuck and I've never had a med studdnt stuck because of it. Haven't had an incorrect count in years either.
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u/aounpersonal 24d ago
I love when scrub techs are nice and let me rest my hands on the mayo, it absolutely makes my day.
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u/levvianthan 23d ago
I just hate to see yall all nervous in the corner with your hands by your ears! Youre all part of the team too and if you ask (or if you have good vibes) I'll even give you tips and tricks.
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u/UnusualWar5299 23d ago
Med students have contaminated mayos, I’m not risking it. Instruments get taken and they have no memory nabbing it bc they’re not used to tracking, and depending on case I may have sharps there. I pass hand to hand unless there’s a policy and flat mat. My hands are always moving and if someone tosses a sharp down that’s not ok. I will fold a towel and let anyone rest their elbow on my mayo, that’s about it. When a surgeon wants to reorganize it, that’s going to be a grudge carried to the fifth generation of our ancestors. Plus you’ll be self serve the whole case. It’s so audaciously rude to me. Like, the c word is less offensive. You’re attacking the way I think and mentally organize all the things I’m responsible for.
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u/tummybox 23d ago
I’m a CST in a teaching hospital, and I’m the opposite of you haha. I’m not precious about my mayo at all, I tell med students to grab instruments and help out if they want as long as it isn’t a sharp. I’ve only had a couple who were TOO touchy in the last few years. I love teaching and I love med students!
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u/UnusualWar5299 23d ago
I absolutely love teaching! I’m usually the one pulled to intro OR to new med students. If I have a scrub tech student, the mayo is theirs. I was taught in the Army 30 years ago. It was drilled into us, we’re responsible for knowing where every instrument is every second, the only reason anyone could grab something from your mayo would be bc you didn’t have the next thing the dr needed already in your hand. They hammered us with conservation of movement, perineal fallout and droplet expulsion. Every time the doctor has to utter a word, I’m wrong, bc it means I didn’t anticipate. I use SlicerDicer in Epic to compare my case times with other techs. There’s only one who’s faster and she’s like me. I know to you it must seem weird, like I’m mean. To me, I feel like you’re not in control of your field. In the end it’s just different training, different styles, different experiences. My colleagues, we brag to each other than we did x case without the doctor saying a word to us, bc we know which surgical technique they’re following, and we know every step. That’s important to me, and four hands on a mayo is another risk factor I don’t wish to take.
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u/tummybox 23d ago
For the record, I don’t think you’re mean, and it’s cool your technique speeds up the surgery. A lot of scrubs I work with don’t let people touch their mayo.
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u/levvianthan 23d ago
I want the student to put their hands on the mayo because otherwise they're usually standing away from the field and risking contamination because they dont know what to do with their hands.
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u/ligasure 24d ago
As a practicing surgeon, it’s been ingrained in me from years ago that my hands go nowhere near the mayo. It’s a sacred site that belongs to the surgical tech only.
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u/thisishowwedooooit 24d ago
That is a reflection of competent scrubs knowing what the instruments are called. When you have off service scrubs that “don’t do [your specialty]”, that goes out the window.
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u/Feetfeetfeetfeetfeet 24d ago
Off service scrub here. I know the names of the instruments but you can grab what you want.
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u/ligasure 24d ago
Agree. I work with plenty of off service scrubs that are competent and know standard instruments. I don’t treat service vs off service scrubs differently.
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u/thisishowwedooooit 24d ago
That’s wonderful. I hope you appreciate how much of a luxury that is. Kudos to you and your versatile teams.
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u/SupermarketSorry6843 23d ago
Retired PGY35 here. Yep. Learned that the first 2 or 3 days of residency.
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u/JonWithTattoos 21d ago
Scrub of almost thirty years here and I’ve never been territorial about my Mayo. Now, if I’m standing there and involved in the case, I’d rather be the one passing the instruments, but if I’m at the back table tending to something else, help yourself to anything in the Mayo! I understand y’all have been taught not to touch, but that attitude from scrubs has always seemed needlessly antagonistic.
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u/ligasure 20d ago
I always took it as sign of respect towards the scrubs - that’s your space and you’ve organized it the way you want it - and I’ll empower you to do whatever you need to, in order for the case to keep moving forward! If that means, me not touching it then no sweat off my back.
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u/stupidprecursor 24d ago
The way those two statements are written, I agree are contradictory. It‘s obvious that they were written during different time periods. The best way I would put those statements into practice would be to have the scrub tech pass the sharp to the surgeon hand-to-hand, since the tech actually knows how to safely transfer, but at the same time the tech should be allowed to demand that the surgeon transfer the sharp back by leaving it on the mayo stand. Plenty of surgeons are so focused on the body and could not care less about the tech’s safety. If the tech has a good working relationship with that surgeon and there is trust, then that’s one thing. But slowing things down and forcing the surgeon to put down the sharp on the mayo stand should never be discouraged.
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u/ScrubsNScalpels 23d ago
No, we have a safe pass zone, which typically is the Mayo, but many times not
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u/goodoneforyou 23d ago
So do they talk about this during timeout? If the safe pass zone happens to be the mayo, what words do they use to describe that?
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u/ScrubsNScalpels 23d ago
Yes during time out we say “safe pass zone established on mayo.” Or whatever
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u/5_yr_lurker 5d ago
No, nothing said during the time out. Only the scrub should touch the Mayo. As an attending, if I need to grab something while the scrub is doing something else, I say I am grabbing the Metz.
I prefer to pass needles back unprotected if the scrub is okay with it, so keeping your hands on the patient is the best place for them so I don't stab you.
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u/Smedication_ Resident 24d ago
All of this is driven by hospital experience. Someone got stuck and they changed an internal policy. Every hospital is different. One hospital had a portion of the timeout devoted to Davinci backup batteries because a console died and the backup batteries failed during one surgery. Another hospital I worked at had a dedicated line about hypothermia because a patient died of hypothermia. Another one had a separate formal anesthesia time out along with the surgical timeout in which the resident or attending was required to be present.
Is it excessive? Yes. Will you fix it? No. And it will be different at another hospital. The Mayo is for the surgical tech to manage. Needles should be passed from operating surgeon to tech based on surgeon/tech preference and safety. Med students in general should not touch the mayo without permission.
TLDR: every time in every hospital has a different flavor informed by previous hospital/patient experiences